Liberation From Venoarterial Extracorporeal Membrane Oxygenation: A Review
Venoarterial extracorporeal membrane oxygenation may be used for circulatory support in cardiogenic shock as a bridge to recovery, a bridge to a ventricular assist device (VAD), or a bridge to transplant. While the determination of potential exit strategies is essential before cannulation, the final...
Saved in:
| Published in: | Circulation. Heart failure Vol. 14; no. 7; p. e007679 |
|---|---|
| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Lippincott Williams & Wilkins
01-07-2021
|
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Venoarterial extracorporeal membrane oxygenation may be used for circulatory support in cardiogenic shock as a bridge to recovery, a bridge to a ventricular assist device (VAD), or a bridge to transplant. While the determination of potential exit strategies is essential before cannulation, the final determination of a patient’s options may change, in part, through their in-hospital clinical course. We propose that liberation from venoarterial extracorporeal membrane oxygenation should be conceptualized as a process of discovery in the assessment of a patient’s underlying clinical status and a key driver of further clinical decision-making. A trial of liberation from support should be considered when the goals of the weaning trial are well-defined and, ideally, in the absence of potentially confounding clinical factors. In this review, we will discuss readiness to wean criteria from venoarterial extracorporeal membrane oxygenation, as well as specific clinical, biochemical, and echocardiographic parameters that may prove useful in determining weaning timing and revealing the patient’s underlying hemodynamic status and prognosis. The role of various cannula configurations, support devices, and pharmacological adjuncts will also be discussed. Finally, we highlight current gaps in evidence and suggest areas of future research. |
|---|---|
| AbstractList | Venoarterial extracorporeal membrane oxygenation may be used for circulatory support in cardiogenic shock as a bridge to recovery, a bridge to a ventricular assist device (VAD), or a bridge to transplant. While the determination of potential exit strategies is essential before cannulation, the final determination of a patient's options may change, in part, through their in-hospital clinical course. We propose that liberation from venoarterial extracorporeal membrane oxygenation should be conceptualized as a process of discovery in the assessment of a patient's underlying clinical status and a key driver of further clinical decision-making. A trial of liberation from support should be considered when the goals of the weaning trial are well-defined and, ideally, in the absence of potentially confounding clinical factors. In this review, we will discuss readiness to wean criteria from venoarterial extracorporeal membrane oxygenation, as well as specific clinical, biochemical, and echocardiographic parameters that may prove useful in determining weaning timing and revealing the patient's underlying hemodynamic status and prognosis. The role of various cannula configurations, support devices, and pharmacological adjuncts will also be discussed. Finally, we highlight current gaps in evidence and suggest areas of future research. |
| Author | Brahmbhatt, Darshan H. Billia, Filio Daly, Andrea L. Fan, Eddy Luk, Adriana C. |
| Author_xml | – sequence: 1 givenname: Darshan H. surname: Brahmbhatt fullname: Brahmbhatt, Darshan H. organization: Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (D.H.B., A.L.D., A.C.L., F.B.) – sequence: 2 givenname: Andrea L. surname: Daly fullname: Daly, Andrea L. organization: Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (D.H.B., A.L.D., A.C.L., F.B.) – sequence: 3 givenname: Adriana C. surname: Luk fullname: Luk, Adriana C. organization: Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (D.H.B., A.L.D., A.C.L., F.B.) – sequence: 4 givenname: Eddy surname: Fan fullname: Fan, Eddy organization: Interdepartmental Division of Critical Care Medicine (E.F.), University of Toronto, ON, Canada – sequence: 5 givenname: Filio surname: Billia fullname: Billia, Filio organization: Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (D.H.B., A.L.D., A.C.L., F.B.) |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34247519$$D View this record in MEDLINE/PubMed |
| BookMark | eNpdkE9vEzEQxS1URP_AV0ArceGy6YzttWM4RVFCg4IqRS1Xy_HO0oXddbA3TfvtMU1BiMPIY-k9P7_fOTsZwkCMvUOYICq8nK8286vFbHOznK3Wt5vFBDlMALTS5gU7QyOxFNzok3_2U3ae0ncAxavKvGKnQnKpKzRn7PO63VJ0YxuGYhlDX3ylIbg4UmxdVywexuh8iLsQKV-_UL-NbqDi-uHxGw1Prg_FrNjQfUuH1-xl47pEb57PC3a7XNzMr8r19afVfLYuvUQDZc29505UTiJoV00RGi9r1SgA70kr9DUqLupKkVHOGKplA1oi6txzulXigr0_vruL4eee0mj7NnnquvyzsE82d8xFtZjKLP14lPoYUorU2F1sexcfLYL9DdP-D9PmEHuEmd1vn4P2257qv94_9LJAHgWH0GVi6Ue3P1C0d5nVeGcBhdDSyJIDz1UBoMyDIH4BvQ6DAA |
| CitedBy_id | crossref_primary_10_1053_j_jvca_2023_09_011 crossref_primary_10_1161_CIRCHEARTFAILURE_121_009183 crossref_primary_10_1161_CIRCHEARTFAILURE_121_009260 crossref_primary_10_1161_CIRCHEARTFAILURE_121_009079 crossref_primary_10_1007_s00134_024_07333_7 crossref_primary_10_1097_MCC_0000000000000939 crossref_primary_10_1053_j_jvca_2024_05_018 crossref_primary_10_1016_j_jtcvs_2021_09_041 crossref_primary_10_14503_THIJ_23_8171 crossref_primary_10_1002_ehf2_14441 crossref_primary_10_1177_02676591241258689 |
| Cites_doi | 10.1532/hsf.1780 10.1186/cc13746 10.1186/s13054-016-1519-7 10.1097/MAT.0b013e3182768b68 10.1177/1074248414559838 10.1097/MAT.0b013e31829f5e9f 10.1111/jocs.13146 10.1007/s00134-016-4657-0 10.1093/icvts/ivx155 10.1053/j.jvca.2016.03.139 10.1093/ejcts/ezy485 10.1016/j.echo.2017.09.004 10.1177/0267659120956540 10.1152/ajpheart.00603.2014 10.1177/0267659117745369 10.1016/j.jtcvs.2015.02.043 10.1002/ejhf.850 10.1016/s0022-5223(96)70315-x 10.1177/0267659120941328 10.3978/j.issn.2072-1439.2015.07.17 10.1053/j.jvca.2017.08.048 10.1053/j.jvca.2014.12.011 10.1177/0267659115581197 10.1016/j.ahj.2003.07.006 10.1016/j.jacc.2015.10.017 10.1016/j.athoracsur.2013.09.008 10.1097/MAT.0000000000000661 10.1510/icvts.2011.269795 10.1002/ehf2.12291 10.1177/0267659118794112 10.1016/j.healun.2009.08.025 10.1002/ccd.28329 10.1177/0885066619900503 10.1161/CIR.0000000000000525 10.1161/CIRCULATIONAHA.120.048792 10.1097/CCM.0000000000000410 10.1186/s13054-017-1855-2 10.1016/j.ccc.2017.06.006 10.3978/j.issn.2225-319X.2012.07.12 10.1053/j.jvca.2021.01.056 10.1097/MAT.0000000000000043 10.1016/j.jtcvs.2013.06.055 10.1016/j.jacc.2018.10.085 10.1186/s13054-017-1633-1 10.1510/icvts.2009.228346 10.1007/s00134-011-2358-2 10.5090/kjtcs.2016.49.3.203 10.1016/j.jtcvs.2018.03.123 10.1177/0267659118755888 10.1097/MAT.0b013e3182a4b32e 10.1002/ccd.21160 10.1093/ejcts/ezx510 10.4070/kcj.2019.0188 10.1186/cc11467 10.1007/s12350-009-9127-4 10.1155/2017/3505784 10.1253/circj.CJ-16-1308 10.1177/0267659119841862 10.1016/j.healun.2021.01.009 10.1016/j.resuscitation.2012.12.019 10.1016/j.ejcts.2010.12.050 10.1536/ihj.20-172 10.1186/cc13702 10.1186/s13054-016-1261-1 10.1016/j.jtcvs.2010.07.017 10.1186/cc3877 10.1007/s12265-020-10078-5 10.1097/MAT.0000000000001024 10.1111/j.1540-8191.2011.01400.x 10.1161/CIRCHEARTFAILURE.119.006486 10.1159/000439444 10.1164/rccm.201610-2076ST 10.1016/j.echo.2012.02.009 |
| ContentType | Journal Article |
| Copyright | Lippincott Williams & Wilkins |
| Copyright_xml | – notice: Lippincott Williams & Wilkins |
| DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
| DOI | 10.1161/CIRCHEARTFAILURE.120.007679 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef MEDLINE - Academic |
| DatabaseTitleList | MEDLINE CrossRef |
| Database_xml | – sequence: 1 dbid: ECM name: MEDLINE url: https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&site=ehost-live sourceTypes: Index Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1941-3297 |
| EndPage | e007679 |
| ExternalDocumentID | 10_1161_CIRCHEARTFAILURE_120_007679 34247519 01337494-202107000-00010 |
| Genre | Journal Article Review |
| GroupedDBID | --- .XZ .Z2 0R~ 18M 29B 53G 5GY 5VS 6J9 AAAAV AAHPQ AAIQE AAJCS AARTV AASCR ABASU ABBUW ABDIG ABJNI ABVCZ ABXVJ ACDDN ACEWG ACGFO ACGFS ACILI ACWDW ACWRI ACXJB ACXNZ ADBBV ADGGA ADHPY AEBDS AFDTB AFEXH AGINI AHQNM AHVBC AINUH AJIOK AJNWD AJZMW ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW BAWUL BQLVK C45 CS3 DIK DIWNM E.X E3Z EBS EEVPB EX3 F5P FCALG FL- GNXGY GQDEL HLJTE HZ~ IKREB IN~ JF7 KD2 KQ8 KQB L-C O9- ODMTH ODZKP OHYEH OK1 OPUJH OVD OVDNE OXXIT P6G RAH RHF RLZ S4S TEORI TR2 TSPGW V2I W2D W3M W8F WOW ABZAD ADNKB AEETU AFUWQ AHRYX AJNYG CGR CUY CVF DUNZO ECM EIF EJD H13 IPNFZ NPM OUVQU RIG ZZMQN AAYXX CITATION 7X8 |
| ID | FETCH-LOGICAL-c4190-d2cc2a35a4107a5810fc4d6f600cce761cd1623d56e96a99ed4f0741171208b63 |
| ISSN | 1941-3297 1941-3289 |
| IngestDate | Sat Aug 17 01:39:44 EDT 2024 Fri Aug 23 01:25:38 EDT 2024 Sat Sep 28 08:30:27 EDT 2024 Thu Nov 14 19:01:55 EST 2024 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 7 |
| Language | English |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-c4190-d2cc2a35a4107a5810fc4d6f600cce761cd1623d56e96a99ed4f0741171208b63 |
| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 |
| ORCID | 0000-0002-2824-1215 0000-0001-8439-5262 0000-0003-3440-0523 |
| OpenAccessLink | https://www.ahajournals.org/doi/pdf/10.1161/CIRCHEARTFAILURE.120.007679 |
| PMID | 34247519 |
| PQID | 2550627384 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2550627384 crossref_primary_10_1161_CIRCHEARTFAILURE_120_007679 pubmed_primary_34247519 wolterskluwer_health_01337494-202107000-00010 |
| PublicationCentury | 2000 |
| PublicationDate | 2021-July-01 2021-07-00 20210701 |
| PublicationDateYYYYMMDD | 2021-07-01 |
| PublicationDate_xml | – month: 07 year: 2021 text: 2021-July-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Circulation. Heart failure |
| PublicationTitleAlternate | Circ Heart Fail |
| PublicationYear | 2021 |
| Publisher | Lippincott Williams & Wilkins |
| Publisher_xml | – name: Lippincott Williams & Wilkins |
| References | e_1_3_3_50_2 e_1_3_3_75_2 e_1_3_3_71_2 e_1_3_3_77_2 e_1_3_3_16_2 e_1_3_3_18_2 e_1_3_3_39_2 e_1_3_3_12_2 e_1_3_3_58_2 e_1_3_3_14_2 e_1_3_3_35_2 e_1_3_3_56_2 e_1_3_3_33_2 e_1_3_3_54_2 e_1_3_3_10_2 e_1_3_3_31_2 e_1_3_3_52_2 e_1_3_3_73_2 e_1_3_3_40_2 e_1_3_3_61_2 e_1_3_3_5_2 e_1_3_3_7_2 e_1_3_3_9_2 e_1_3_3_27_2 e_1_3_3_29_2 e_1_3_3_23_2 e_1_3_3_48_2 e_1_3_3_69_2 e_1_3_3_25_2 e_1_3_3_46_2 e_1_3_3_67_2 e_1_3_3_44_2 e_1_3_3_65_2 e_1_3_3_3_2 e_1_3_3_21_2 e_1_3_3_42_2 e_1_3_3_63_2 e_1_3_3_51_2 e_1_3_3_74_2 e_1_3_3_76_2 e_1_3_3_70_2 e_1_3_3_17_2 e_1_3_3_19_2 e_1_3_3_38_2 e_1_3_3_13_2 e_1_3_3_36_2 e_1_3_3_59_2 e_1_3_3_15_2 e_1_3_3_34_2 e_1_3_3_57_2 (e_1_3_3_2_2) 2020 e_1_3_3_32_2 e_1_3_3_55_2 e_1_3_3_11_2 e_1_3_3_30_2 e_1_3_3_53_2 e_1_3_3_72_2 e_1_3_3_62_2 e_1_3_3_60_2 Aissaoui N (e_1_3_3_37_2) 2016 e_1_3_3_6_2 e_1_3_3_8_2 e_1_3_3_28_2 e_1_3_3_49_2 e_1_3_3_24_2 e_1_3_3_47_2 e_1_3_3_26_2 e_1_3_3_45_2 e_1_3_3_68_2 e_1_3_3_20_2 e_1_3_3_43_2 e_1_3_3_66_2 e_1_3_3_4_2 e_1_3_3_22_2 e_1_3_3_41_2 e_1_3_3_64_2 |
| References_xml | – ident: e_1_3_3_25_2 doi: 10.1532/hsf.1780 – ident: e_1_3_3_8_2 doi: 10.1186/cc13746 – ident: e_1_3_3_53_2 doi: 10.1186/s13054-016-1519-7 – ident: e_1_3_3_7_2 doi: 10.1097/MAT.0b013e3182768b68 – ident: e_1_3_3_75_2 doi: 10.1177/1074248414559838 – ident: e_1_3_3_45_2 – ident: e_1_3_3_51_2 doi: 10.1097/MAT.0b013e31829f5e9f – ident: e_1_3_3_65_2 doi: 10.1111/jocs.13146 – ident: e_1_3_3_50_2 doi: 10.1007/s00134-016-4657-0 – ident: e_1_3_3_38_2 doi: 10.1093/icvts/ivx155 – ident: e_1_3_3_77_2 doi: 10.1053/j.jvca.2016.03.139 – volume-title: In: Extracorporeal Membrane Oxygenation – Advances in Therapy year: 2016 ident: e_1_3_3_37_2 contributor: fullname: Aissaoui N – ident: e_1_3_3_56_2 doi: 10.1093/ejcts/ezy485 – ident: e_1_3_3_30_2 doi: 10.1016/j.echo.2017.09.004 – ident: e_1_3_3_64_2 doi: 10.1177/0267659120956540 – ident: e_1_3_3_46_2 doi: 10.1152/ajpheart.00603.2014 – ident: e_1_3_3_9_2 doi: 10.1177/0267659117745369 – ident: e_1_3_3_26_2 doi: 10.1016/j.jtcvs.2015.02.043 – ident: e_1_3_3_69_2 doi: 10.1002/ejhf.850 – ident: e_1_3_3_21_2 doi: 10.1016/s0022-5223(96)70315-x – ident: e_1_3_3_55_2 doi: 10.1177/0267659120941328 – ident: e_1_3_3_20_2 doi: 10.3978/j.issn.2072-1439.2015.07.17 – ident: e_1_3_3_6_2 doi: 10.1053/j.jvca.2017.08.048 – ident: e_1_3_3_12_2 doi: 10.1053/j.jvca.2014.12.011 – ident: e_1_3_3_54_2 doi: 10.1177/0267659115581197 – ident: e_1_3_3_52_2 doi: 10.1016/j.ahj.2003.07.006 – ident: e_1_3_3_58_2 doi: 10.1016/j.jacc.2015.10.017 – ident: e_1_3_3_5_2 doi: 10.1016/j.athoracsur.2013.09.008 – ident: e_1_3_3_48_2 doi: 10.1097/MAT.0000000000000661 – ident: e_1_3_3_72_2 doi: 10.1510/icvts.2011.269795 – ident: e_1_3_3_40_2 doi: 10.1002/ehf2.12291 – ident: e_1_3_3_60_2 doi: 10.1177/0267659118794112 – ident: e_1_3_3_31_2 doi: 10.1016/j.healun.2009.08.025 – ident: e_1_3_3_4_2 doi: 10.1002/ccd.28329 – ident: e_1_3_3_47_2 doi: 10.1177/0885066619900503 – ident: e_1_3_3_3_2 doi: 10.1161/CIR.0000000000000525 – ident: e_1_3_3_63_2 doi: 10.1161/CIRCULATIONAHA.120.048792 – volume-title: Extracorporeal Life Support Organization year: 2020 ident: e_1_3_3_2_2 – ident: e_1_3_3_22_2 doi: 10.1097/CCM.0000000000000410 – ident: e_1_3_3_33_2 doi: 10.1186/s13054-017-1855-2 – ident: e_1_3_3_28_2 doi: 10.1016/j.ccc.2017.06.006 – ident: e_1_3_3_70_2 doi: 10.3978/j.issn.2225-319X.2012.07.12 – ident: e_1_3_3_62_2 doi: 10.1053/j.jvca.2021.01.056 – ident: e_1_3_3_15_2 doi: 10.1097/MAT.0000000000000043 – ident: e_1_3_3_36_2 doi: 10.1016/j.jtcvs.2013.06.055 – ident: e_1_3_3_61_2 doi: 10.1016/j.jacc.2018.10.085 – ident: e_1_3_3_11_2 doi: 10.1186/s13054-017-1633-1 – ident: e_1_3_3_71_2 doi: 10.1510/icvts.2009.228346 – ident: e_1_3_3_29_2 doi: 10.1007/s00134-011-2358-2 – ident: e_1_3_3_67_2 doi: 10.5090/kjtcs.2016.49.3.203 – ident: e_1_3_3_41_2 doi: 10.1016/j.jtcvs.2018.03.123 – ident: e_1_3_3_43_2 doi: 10.1177/0267659118755888 – ident: e_1_3_3_76_2 doi: 10.1097/MAT.0b013e3182a4b32e – ident: e_1_3_3_23_2 doi: 10.1002/ccd.21160 – ident: e_1_3_3_42_2 doi: 10.1093/ejcts/ezx510 – ident: e_1_3_3_68_2 doi: 10.4070/kcj.2019.0188 – ident: e_1_3_3_18_2 doi: 10.1186/cc11467 – ident: e_1_3_3_24_2 doi: 10.1007/s12350-009-9127-4 – ident: e_1_3_3_39_2 doi: 10.1155/2017/3505784 – ident: e_1_3_3_66_2 doi: 10.1253/circj.CJ-16-1308 – ident: e_1_3_3_57_2 doi: 10.1177/0267659119841862 – ident: e_1_3_3_10_2 doi: 10.1016/j.healun.2021.01.009 – ident: e_1_3_3_14_2 doi: 10.1016/j.resuscitation.2012.12.019 – ident: e_1_3_3_16_2 doi: 10.1016/j.ejcts.2010.12.050 – ident: e_1_3_3_73_2 doi: 10.1536/ihj.20-172 – ident: e_1_3_3_32_2 doi: 10.1186/cc13702 – ident: e_1_3_3_27_2 doi: 10.1186/s13054-016-1261-1 – ident: e_1_3_3_13_2 doi: 10.1016/j.jtcvs.2010.07.017 – ident: e_1_3_3_44_2 doi: 10.1186/cc3877 – ident: e_1_3_3_17_2 doi: 10.1007/s12265-020-10078-5 – ident: e_1_3_3_74_2 doi: 10.1097/MAT.0000000000001024 – ident: e_1_3_3_35_2 doi: 10.1111/j.1540-8191.2011.01400.x – ident: e_1_3_3_59_2 doi: 10.1161/CIRCHEARTFAILURE.119.006486 – ident: e_1_3_3_19_2 doi: 10.1159/000439444 – ident: e_1_3_3_34_2 doi: 10.1164/rccm.201610-2076ST – ident: e_1_3_3_49_2 doi: 10.1016/j.echo.2012.02.009 |
| SSID | ssj0062559 |
| Score | 2.4153075 |
| SecondaryResourceType | review_article |
| Snippet | Venoarterial extracorporeal membrane oxygenation may be used for circulatory support in cardiogenic shock as a bridge to recovery, a bridge to a ventricular... |
| SourceID | proquest crossref pubmed wolterskluwer |
| SourceType | Aggregation Database Index Database Publisher |
| StartPage | e007679 |
| SubjectTerms | Extracorporeal Membrane Oxygenation - instrumentation Extracorporeal Membrane Oxygenation - methods Heart Failure - etiology Heart-Assist Devices - adverse effects Hemodynamics - physiology Humans Risk Factors Shock, Cardiogenic - physiopathology Shock, Cardiogenic - therapy |
| Title | Liberation From Venoarterial Extracorporeal Membrane Oxygenation: A Review |
| URI | http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=01337494-202107000-00010 https://www.ncbi.nlm.nih.gov/pubmed/34247519 https://search.proquest.com/docview/2550627384 |
| Volume | 14 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV3da9swEBdrCmVjjH0v-8JjeyvuLFuRrL15iU07sha6ZPRNyJZMSltnODHr_vudLMd2Vhjdw16MEURy7n6c7vsQ-uApnqZSjVyPqdwlOuRuGvLUzTzGuKY5wboeYvuNHZ-Fk5jEnTOnW_uvnIY14LWpnP0HbrebwgK8A8_hCVyH5634XqeAWK4mpnTkuy6Wdd6mcY3H1-sSRKBpXqzrotwrMJZBzTy5_gUbtokeUT9ksGljcF5mzaivA1O8VK73c3l-WZX9sPziKl1IG26agMW8AOHRhqIm0g61rlMo5X7rdJ5WtUCOFHxhITuvbWJds7Fq2t82rgkft2mscLNYccoJdgPfZuC28pb0cMV6wlObsKAdLdPcxb2Vm6KeGlE_PjodH8ag-yfR0XR-Gh9g3-Tqdfv0G2wfn4hkPp2KWXw220G7Psim0QDtRslk9nlzfVNjY-2h980RH_9ywLYqc8M-uYfu_1yalIfVRV3x0NNbZg_Rg8bgcCKLlEfoji4eo72vTUrFE_SlA4xjAOP0AeNsA8bZAMbpAeaTEzkWLk_RPIln40O3GbDhZsS0EFB-lvkyGEmCPSZHIfbyjCiagxKcZZpRnCkM6rEaUc2p5FwrkhsVFDMgQpjS4BkaFMtCv0COpAE1fd4D0GDBBpYpD3muvDSDn0iZsiEiG1qJH7aPiqjtT4rFnyQWsLuwJB6idxu6CpB7JpgFf3JZrQSwyXTYDkIyRM8twduNA-ITBqbJELlbHBC2tliA2RMwwolrQAt3nm2ugL2XtzjtFbrbQf01GqzLSr9BOytVvW2Q9Bv8R4v7 |
| link.rule.ids | 315,782,786,27935,27936,64552,64572,65347,65367 |
| linkProvider | Ovid |
| linkToHtml | http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwvV1Lb9QwELaglQoI8X4szyBQbmnzcOwYKYeQTdgtuwvqboGerCR2LqhJtQ8o_54ZJ4sKiAMXTomU2Ioz4_E3nm_GhLxylSjLQoWOy1XtUB0Jp4xE6VQu50KzmnraHGI757PP0TDDMjlbriomn63O9vFizDTe4HE46Bcu4sO5Pcs-zePGTudpfGJ_SN5mZpsaSRL2MG6_1ms7mcUAawJOBQUVAI-G98nTmIi1y8KAgY-2m-TDxZutyWaIq034mXpO4Au-R14aa8K8g3R8lI4yAJd5Mp4cH2X7no9kMM6Q_HVxKfsDn14j17-1GPJefTGM9wvrVn7zP434FrnRA1sr6TTxNrmkmztkb9qH7u-SQ8NNMXpg5cv21Pqom9YQSmEGWNn5egm2GasqA3K1pvoUvPhGW-_Pv4OGm1avrcTqIhn3yHGeLdKR0x_k4FQUU9WVX1V-EYQFhW8rwshz64oqVgPYqirNmVcpD2CYCpkWrBBCK1oj1PE4_OyoZMF9stO0jX5IrIIFDOuJB4CUwNcqShGJWrllBU2KouQDQrcykWddvQ5p_Bzmyd9FKaF32YlyQF5s5SdhfmHQBAbZblYSVAMrOQcRHZAHnWB_dhxQn3KAwAPi_CJp2eWwyr9J5dE_vv-cXBktphM5Gc_ePSZX8WnHGH5CdtbLjX5KLq_U5lmv1T8Am_n9Vg |
| linkToPdf | http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwvV1Jb9QwFH6CqTQCIfZlWINAuaVkcewYKYcok9CU6VB1WpaTlcTOBTWpZoH23_PsZFABceDCKZESW3G-5-fv-S0GeO1KXlWlDB2XycYhKuJOFfHKqV3GuKIN8ZQ5xHbB5p-jaabL5Gw9-Dr5bHW2qy9GTesbfRyOtguP4_2FnS7S-Is9zz4t4rl9mLzLzDa1DpKwD6d5fGFP4-5bs7aTeYzkJmCEExQEtGvYkEKt07F2KAlDfwQ7SVrMiq3ipppdGyc08ZzA52wMr4xOod6btDhK9zKkmHlSzE6Osl3P1yFhjOoQsMsL2h8s9Trc-N5px_fqq4l7v7R65bf-67hvw82B5FpJL5V34Ipq78L4YHDj34N9E6diZMLKl92p9VG1nQkuxdlgZefrJeppXWEZWax1oE7Rom-V9eH8AqXdtHprJVbv1bgPJ3l2nO45w6EOTk102rr069ovg7Ak-G1lGHluUxNJGyReda0Y9WrpISWTIVWclpwrSRpNezyGvzyqaPAARm3XqkdglTSgurZ4gKwJ7a6y4hFvpFvV2KQsKzYBskVGnPW1O4SxeagnfgdUYO-iB3QCL7coCpxr2oGCg-w2K4ECoqs6BxGZwMMe3p8dB8QnDOnwBJxf8BZ9Pqv4GyqP__H9FzBGwMWsmL9_Atf0wz54-CmM1suNegZXV3LzfBDtHwYZAD4 |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Liberation+From+Venoarterial+Extracorporeal+Membrane+Oxygenation%3A+A+Review&rft.jtitle=Circulation.+Heart+failure&rft.au=Brahmbhatt%2C+Darshan+H&rft.au=Daly%2C+Andrea+L&rft.au=Luk%2C+Adriana+C&rft.au=Fan%2C+Eddy&rft.date=2021-07-01&rft.eissn=1941-3297&rft.volume=14&rft.issue=7&rft.spage=e007679&rft.epage=e007679&rft_id=info:doi/10.1161%2FCIRCHEARTFAILURE.120.007679&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1941-3297&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1941-3297&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1941-3297&client=summon |